Exam 3
Quad Function Model correct answersFinancing- employer/ individual buys
insurance Insurance- insurance agency/ government determines package
Payment-reimbursement of the provider by the
insurance/patient Delivery- provider delivers service
Insurance correct answersTo protect against
catastrophic risks
Risk correct answersThe possibility of substantial financial loss from some
event where probability of occurrence is small
Moral Hazard correct answersLack of incentive to guard against risk
where one is protected from its consequences by insurance
Premium correct answersAmount charged by insurer to unsure against
risk
Out-of-pocket payments correct answersexpenses that are not
reimbursed by insurance
-deductible
-co-insurance
-co payment
Cost Sharing correct answersThe share of costs covered by your
insurance that you pay out of your pocket
Deductible correct answersA specific amount of money that the insured must
pay before an insurance company will pay a claim
Co- Payment correct answersa payment made by a beneficiary in addition to
that made by an insurer
Co-Insurance correct answersA type of insurance in which the insured pays
a share of the payment made against a claim
Group Insurance Policy correct answersProvides group insurance plan to a
select group
Medigap correct answersHelps pay for some of the healthcare costs that
medicare does not cover
Self-insurance correct answersThe employer assumes financial risks for the
employee